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Individual

MR. DAVID B BROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
220 N MAIN AVE, SCRANTON, PA 18504-3304
(570) 341-5012
(570) 341-5092
Mailing address
225 ELECTRIC ST, CLARKS SUMMIT, PA 18411-1933
(570) 586-4183

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC004240L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OC004240L
OT LICENSE
PA
Enumeration date
03/31/2016
Last updated
03/31/2016
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